Individual
JONATHAN CORREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10780 SANTA MONICA BLVD, SUITE 280, LOS ANGELES, CA 90025-4749
(310) 312-5050
(310) 575-9292
Mailing address
10780 SANTA MONICA BLVD. STE 280, LOS ANGELES, CA 90025-4749
(310) 312-5050
(310) 575-9292
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
Primary
G53016
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G53016
LICENSE
CA
01
—
ZZZ73295Z
BLUE SHIELD
CA
Enumeration date
08/30/2006
Last updated
10/07/2014
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